Physical Exercise Helps Women with Breast Cancer to Better Tolerate Chemotherapy

“Women with breast cancer who follow a physical exercise program during their chemotherapy treatment experience less side effects like fatigue, reduced physical fitness, nausea and pain. It is also less often necessary to adjust the dosage of their chemotherapy. This is shown by a study supervised by Neil Aaronson of the Netherlands Cancer Institute (NKI).

“Chemotherapy can be very burdensome for patients. Because of the side effects, not all patients are able to complete their chemotherapy as originally planned, but require a dose adjustment. There are some indications that physical exercise might help reduce these side effects. Neil Aaronson of the NKI was interested in determining which type of physical exercise programs are most effective, and whether such programs can also help patients better tolerate their chemotherapy. He investigated these issues in a group of women with breast cancer who received adjuvant chemotherapy. The research project, nicknamed PACES, was for a large part carried out by PhD student Hanna van Waart of Aaronson’s research group, in close collaboration with the Physical Therapy department of the NKI. The results of the project are now published in the Journal of Clinical Oncology.

“Aaronson and Van Waart randomly divided 230 breast cancer patients into three groups. The first group followed a moderately intensive aerobic and strength exercise program, under supervision of a trained physiotherapist. Women in the second group were assigned to a low intensity aerobic exercise program that they could follow at home, which was coached by a trained nurse or nurse practitioner. The third group did not follow any exercise program. The results of the study were clear. Both groups of women who followed an exercise program experienced less fatigue, loss of fitness, nausea and pain during their chemotherapy treatment. This effect was most pronounced in the group of women who followed the supervised, moderately intensive program. The women in this group were also the ones who endured their chemotherapy best; only twelve percent of them required a dose adjustment. In the control group, 34 percent of the women could not tolerate the chemotherapy and needed a dose adjustment.”


Therapeutic Massage Takes on Cancer Fatigue

“In a continuation of clinical trials related to the biological benefits of massage therapy, Emory researchers are currently studying how massage may help reduce fatigue in breast cancer patients.

“Previous research conducted by Mark Hyman Rapaport, MD, Reunette W. Harris professor and chair of Emory’s Department of Psychiatry and Behavioral Sciences, has already shown that massage therapy can boost the immune system and decrease anxiety for people who do not have cancer.

” ‘We decided to look at massage therapy for cancer fatigue because cancer-related fatigue is one of the most prevalent and debilitating symptoms experienced by people with cancer,’ explains Rapaport, principle investigator for this study. ‘Many studies investigating massage for patients with cancer have been focused on depression, anxiety or pain.’ “


Aerobic Exercise Reduces Fatigue for Women with Breast Cancer Receiving Radiotherapy

“An aerobic exercise program can reduce fatigue in women undergoing radiotherapy for breast cancer, according to a study published in the January issue of the Journal of Clinical Nursing.

“Tsui-Yun Yang, R.N., from the National Taipei University in Taiwan, and colleagues assigned 28 consecutive, willing participants with early-stage breast cancer to an intervention of six weeks of mild- to moderate-intensity aerobic exercise training during their radiotherapy. The next 30 consecutive participants were assigned to routine care without special exercise.

“The researchers observed no group differences in baseline fatigue severity, fatigue interference, or hemoglobin levels. There was a significant group-by-time-interaction effect noted for fatigue severity and interference (P ≤ 0.001), with the fatigue severity and interference decreasing significantly over time for women in the intervention group but increasing over time for women in the control group.”


Report Card on Complementary Therapies for Breast Cancer

“Over eighty percent of breast cancer patients in the United States use complementary therapies following a breast cancer diagnosis, but there has been little science-based guidance to inform clinicians and patients about their safety and effectiveness. In newly published guidelines from the Society for Integrative Oncology, researchers at Columbia University’s Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center with colleagues at MD Anderson Cancer Center, University of Michigan, Memorial Sloan Kettering, and other institutions in the U.S. and Canada, analyzed which integrative treatments appear to be most effective and safe for patients. They evaluated more than 80 different therapies.

“Meditation, yoga, and relaxation with imagery were found to have the strongest evidence supporting their use. They received an “A” grade and are recommended for routine use for anxiety and other mood disorders common to breast cancer patients. The same practices received a “B” grade for reducing stress, depression, and fatigue, but are also endorsed for most breast cancer patients. Acupuncture received a “B” grade for controlling chemotherapy induced nausea and vomiting and can be recommended to most patients. More than 30 interventions, including some natural products and acupuncture for other conditions, had weaker evidence of benefit due to either small study sizes or conflicting study results, and received a “C” grade. Seven other therapies were deemed unlikely to provide any benefit and are not recommended. One therapy was found to be harmful: acetyl-l-carnitine, which is marketed to prevent chemotherapy-related neuropathy, and actually increased risk for the condition.”


New Data on Fatigue from ROMANA 1, a Pivotal Phase III Study of Anamorelin in Advanced NSCLC Patients with Cachexia Presented at 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology

The gist: A new drug called anamorelin might help people with advanced non-small cell lung cancer (NSCLC) who are dealing with cachexia. Cachexia is loss of weight and muscle mass, and weakness. Anamorelin was tested in a clinical trial with volunteer patients who had advanced NSCLC and were suffering from cachexia. The drug appeared to increase the patients’ “lean body mass and body weight, reduce fatigue and improve health-related quality of life.”

“In ROMANA 1, a pivotal Phase III study, anamorelin was shown to increase lean body mass and body weight, reduce fatigue and improve health-related quality of life in patients with advanced NSCLC cachexia.

“Helsinn Group, the Company focused on building quality cancer care, announces that anamorelin, its investigational novel once-daily ghrelin receptor agonist for the treatment of cancer anorexia-cachexia syndrome (CACS), delivered significant improvements in lean body mass [LBM; one of two primary endpoints] in ROMANA 1, a pivotal 12-week Phase III study in non-small cell lung cancer (NSCLC) patients.

“The results underscore the potential for treatment with anamorelin to support the care of patients with CACS, a poorly-understood and debilitating condition that affects a majority of advanced cancer patients but for which existing treatment approaches are limited.

“In the ROMANA 1 trial, over the course of the study, patients treated with anamorelin demonstrated an increase in body weight along with improvements in patient symptoms and concerns, such as appetite, early satiety and fatigue.”


Steroids in Advanced Cancer Don't Help Pain But Boost QOL

The gist: A clinical trial with volunteer patients tested a potentially pain-relieving treatment for people with advanced cancer. The treatment combines opioid therapy (a standard treatment for pain) with a drug called methylprednisolone. The researchers found that the addition of methylprednisolone to opioid therapy did not lessen pain compared to opioid therapy alone, but it boosted quality of life—”less fatigue, better appetite, and better overall satisfaction with their treatment.”

“For patients with advanced cancer, the addition of methylprednisolone to opioid therapy did not help control pain, but it did boost quality of life, according to results from a small randomized trial. Patients who received the corticosteroid reported less fatigue, better appetite, and better overall satisfaction with their treatment than those who did not.

“In the study, patients who received methylprednisolone 16 mg twice daily for 7 days had a lower pain-intensity score (measured on a 10-point scale) than those who received placebo (mean difference, –0.08; P = .88).

“There was no significant difference in pain intensity between the groups at baseline (mean difference, –0.48; P = .50), and no difference in opioid use.

“The study was published online July 7 in the Journal of Clinical Oncology.”


New Clinical Guidelines for Cancer-Related Fatigue

“Fatigue is a debilitating problem for cancer patients undergoing treatment; however, it also poses a huge detriment after treatment and can significantly affect quality of life. Approximately 30 percent of cancer patients endure persistent fatigue for several years after treatment, according to an American Society of Clinical Oncology Expert Panel co-chaired by Paul Jacobsen, Ph.D., associate center director of Population Sciences at Moffitt Cancer Center.”


New Clinical Guidelines for Cancer-Related Fatigue

“Fatigue is a debilitating problem for cancer patients undergoing treatment; however, it also poses a huge detriment after treatment and can significantly affect quality of life. Approximately 30 percent of cancer patients endure persistent fatigue for several years after treatment, according to an American Society of Clinical Oncology Expert Panel co-chaired by Paul Jacobsen, Ph.D., associate center director of Population Sciences at Moffitt Cancer Center.”


New Clinical Guidelines for Cancer-Related Fatigue

“Fatigue is a debilitating problem for cancer patients undergoing treatment; however, it also poses a huge detriment after treatment and can significantly affect quality of life. Approximately 30 percent of cancer patients endure persistent fatigue for several years after treatment, according to an American Society of Clinical Oncology Expert Panel co-chaired by Paul Jacobsen, Ph.D., associate center director of Population Sciences at Moffitt Cancer Center.”